Oral disease is still prevalent in many regions, especially Appalachia, burdened by poor healthcare access and lower socioeconomic levels. Most assessments of risk factors for oral disease focus on one or two organisms or behaviors. This inherently restricts our ability to look at the interactive role of multiple organisms and host genetics that lead to susceptibility for oral disease. Current methods for assessing complex relationships with a large number of risk factors are unable to incorporate more than a few interactions for statistical evaluation. Alternate analytic methods are needed. Network analytic approaches are a promising way to assess high dimension data that may contain multiple interactions simultaneously. The long-term objective of the current application is to assess networks of biologic factors, especially microbial organism and host genetic variation, and their role in oral health. This goal will be met by conducting secondary analyses of data from an oral health study being conducted in the Applachian region (COHRA) using network analytic techniques. Over 2000 COHRA participants have provided oral health outcome, microbial samples, and DNA for genotyping. Detailed caries and periodontal screening measures are available. Both culture and sequence data are available for microbial identification. Single nucleotide polymorphism data will also be available. This application will test for networks of risk factors (microbial and genetic) and provide insight into what risk profiles may exist that correspond to oral health. PUBLIC HEALTH RELEVANCE: Oral health and disease are the result of complex interactions between biologic and environmental factors. Current analyses do not account for these networks of relationships. We propose to evaluate microbial and genetic data obtained from Appalachian subjects using alternative analytic techniques in order to assess whether or not discernable biologic networks are present. Completion of the proposed work will provide better understanding of oral health risk factors and potential points of treatment or intervention.